Bri$sh Sleep Society 2015 Debate
|
|
- Sophie Underwood
- 5 years ago
- Views:
Transcription
1 Bri$sh Sleep Society 2015 Debate The MSLT is an extremely important and useful inves$ga$on in the diagnosis of narcolepsy Dr Ian Morrison Consultant Neurologist NHS Tayside
2 Narcolepsy Derived from the Greek Seized by somnolence First named by a French neurologist, JBE Gelineau S$ll known in certain centres as Gelineau s syndrome Earlier descrip$ons are noted from Carl Friedrich ORo Westphal
3 Frequency Prevalence is 25 to 50 per 100,000 with cataplexy Longstreth et al, Sleep 2007, Vol 30 No1 Incidence data is limited possibly 1.37 per 100,000 person- years with or without cataplexy Silber et al. Sleep 2002; 25: Male to female ra$o is 1:1 Age of onset is variable Two peaks age 15 and 36 Dauvilliers et al. Neurology 2001, 57(11)
4 Age of onset Age of onset is variable Two peaks age 15 and 36 Dauvilliers et al. Neurology 2001, 57(11)
5 Pathophysiology Frequently unrecognised Typical delay of 1 to 61 years in diagnosis, around 10.5 years in UK Morrish et al, Sleep Medicine 2004 (5) % of adults report symptoms beginning as a teenager Can lead to impairment of social and academic performance
6 Socially embarrassing, and source of humour Job impairment from sleep aracks, memory problems In one study, 24% of pa$ents stopped working and 18% were fired Increased risk of death for automobile accidents Cease driving on diagnosis un$l control is achieved Permanent exclusion from Group 2 Morbidity
7 Assessment of Sleepiness Excessive day$me sleepiness is a significant, chronic problem 5% of popula$on Lavie P. Sleep (2): Mul$ple causes Morbidity for pa$ent and those around Mitler et al. Sleep 1988; 11(1):100-0 Important to assess sleepiness accurately Ra$ng scales have variable reliability Epworth and Stanford Scales are subjec$ve, other issues around use
8 Objec$ve markers of sleepiness Ini$al studies used EEG changes to determine sleep onset Davis et al Science 1937; 86: Evolved into Rechtschaffen and Kales scoring system Sleep stages Sleep latency Development of 90 minute day paradigm Correla$ng sleepiness with sleep latency 60 minutes wakefulness, 30 minute sleep Using Stanford Sleepiness Scale and repeat measures of sleep latency Carskadon and Dement Sleep 1982; 5 Suppl 2:S67-72
9 Does sleep latency exactly correlate with sleepiness? Tendency to sleep in the absence of aler$ng factors Sleepiness correlates with short sleep latency Carskadon and Dement. Sleep 1982;5 Suppl 2: S67-72 May also correlate with sleepability Ability to transi$on into sleep Some people have high sleepability without sleepiness Harrison and Horne. Neurophysiol Clin. 1996; 26(1):15-20 Influenced by mul$ple factors
10 Development of MSLT Six volunteers 2 nights sleep depriva$on In bed every 2 hours and told to fall asleep If awake, stopped aner 20 minutes Woken aner one minute of stage 1 Prevent accumula$on of sleep Proven correla$on between depriva$on and sleep latency Carskadon and Dement Sleep Research 1977; 6:200. Carskadon and Dement Percept Mot Skills 1979; 40(2): SOREMPs in narcolepsy iden$fied Rechtschaffen A et al Electoencephalogr Clin Neurophysiol 1963, 15:
11 MSLT in narcolepsy Recent review of 13 papers of MSLT in narcolepsy Included control popula$on in 4 studies MSL for narcolepsy 3mins (+/- 3.1mins) MSL for controls 10.5mins (+/- 4.6mins) 84% of narcolepsy pa$ents meet tradi$onal limit of 5 minutes SOREMPs 10 papers reviewed Presence of cataplexy diagnos$cally sufficient Majority of narcolepsy pa$ents have SOREMPs At least 2 or more Frequency of SOREMPs increase with decreasing latency Sensi$vity of 0.78 and specificity of 0.93 for all studies, Removing one study increased sensi$vity to 0.79 and specificity to 0.98 Studies reviewed by Arand et al Sleep 2005; 28(1):
12 Guidance Difficul$es in accessing sleep studies in UK Limited access Interna$onal Classifica$on of Sleep Disorders (v2) state: while narcolepsy without cataplexy must be confirmed with polysomnography (PSG) and mul$ple sleep latency tes$ng (MSLT), narcolepsy with cataplexy should, whenever possible be confirmed by PSG and MSLT Cataplexy thought to be virtually diagnos$c of narcolepsy
13 Problems Symptoms of narcolepsy can occur in unaffected individuals Sleep paralysis as isolated parasomnia in 50% of adult popula$on Excessive day$me sleepiness has broad differen$al diagnosis Fac$$ous narcolepsy and cataplexy have been described History dependent on experience of clinician
14 European Journal of Neurology 2011, 18: doi: /j x SHORT COMMUNICATION Diagnosing narcolepsy with cataplexy on history alone: challenging the International Classification of Sleep Disorders (ICSD-2) criteria I. Morrison a, J. Bušková b, S. Nevšimalová b, N. J. Douglas c and R. L. Riha c a Department of Neurology, Institute of Neurological Sciences, Glasgow, UK; b Department of Neurology, First Medical Faculty, Charles University, Prague, Czech Republic; and c Department of Sleep Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK Pa$ents were iden$fied over a 5 year period from the records in the Dept of Sleep Medicine All had been previously diagnosed as narcolepsy with cataplexy Referred for 2 nd opinion as not responding to treatment
15
16
17 Inves$ga$ons Exclude other causes HLA- DQB1* % of pa$ents with cataplexy and 56% without cataplexy Mignot et al, Arch. Neurol (10): MRI Controversial. Sugges$on that changes are visible in pons within the RAS Structural abnormali$es of brainstem is a differen$al of idiopathic narcolepsy
18 Other inves$ga$ons Lumbar puncture CSF hypocre$n levels can also be checked, with low CSF hypocre$n levels (less than 110pg/ml or 1/3 of the mean control value) are consistent with narcolepsy Sensi$vity 62%, specificity 98% in narcolepsy Issues of diagnosis not all pa$ents had posi$ve MSLT Mignot et al, Arch. Neurol (10):
19 The MSLT is an extremely important and useful inves$ga$on in the diagnosis of narcolepsy
Sleep Studies: Attended Polysomnography and Portable Polysomnography Tests, Multiple Sleep Latency Testing and Maintenance of Wakefulness Testing
Portable Polysomnography Tests, Multiple Sleep Latency Testing and Maintenance of Wakefulness Testing MP9132 Covered Service: Yes when meets criteria below Prior Authorization Required: Yes as indicated
More informationMisdiagnosis of narcolepsy Dunne, Laura; Patel, Pallavi; Maschauer, Emily L.; Morrison, Ian; Riha, Renata L.
University of Dundee Mis of narcolepsy Dunne, Laura; Patel, Pallavi; Maschauer, Emily L.; Morrison, Ian; Riha, Renata L. Published in: Sleep and Breathing DOI: 10.1007/s11325-016-1365-5 Publication date:
More informationEFFICACY OF MODAFINIL IN 10 TAIWANESE PATIENTS WITH NARCOLEPSY: FINDINGS USING THE MULTIPLE SLEEP LATENCY TEST AND EPWORTH SLEEPINESS SCALE
EFFICACY OF MODAFINIL IN 10 TAIWANESE PATIENTS WITH NARCOLEPSY: FINDINGS USING THE MULTIPLE SLEEP LATENCY TEST AND EPWORTH SLEEPINESS SCALE Shih-Bin Yeh 1 and Carlos Hugh Schenck 2,3 1 Department of Neurology
More informationPORTABLE OR HOME SLEEP STUDIES FOR ADULT PATIENTS:
Sleep Studies: Attended Polysomnography and Portable Polysomnography Tests, Multiple Sleep Latency Testing and Maintenance of Wakefulness Testing MP9132 Covered Service: Prior Authorization Required: Additional
More informationNarcolepsy with long sleep time. Sleep disorder unit, National reference center for narcolepsy and hypersomnia, Pitié-
Narcolepsy with long sleep time: a specific entity? Cyrille Vernet, MSc and Isabelle Arnulf, MD, PhD Sleep disorder unit, National reference center for narcolepsy and hypersomnia, Pitié- Salpêtrière hospital,
More informationNarcolepsy with Cataplexy: An Autoimmune Phenomenon
Fall 2014 Meeting October 3-4, 2014 Narcolepsy with Cataplexy: An Autoimmune Phenomenon Soumya C. Madala MD Mercy Health Sleep Center Grand Rapids, MI Conflict of Interest Disclosures for Speakers 1. I
More informationSleepiness: Its Measurement and Determinants
Sleep, 5:S128-S134 1982 Raven Press, New York Sleepiness: Its Measurement and Determinants T. Roth, T. Roehrs, and F. Zorick Sleep Disorders and Research Center, Henry Ford Hospital, Detroit, Michigan
More informationAutomobile Accidents in Patients with Sleep Disorders
Sleep 12(6):487-494, Raven Press, Ltd., New York 1989 Association of Professional Sleep Societies Automobile Accidents in Patients with Sleep Disorders Michael S. Aldrich Department of Neurology, University
More informationThe Epidemiology of Narcolepsy in Olmsted County, Minnesota: A Population-Based Study
NARCOLEPSY The Epidemiology of Narcolepsy in Olmsted County, Minnesota: A Population-Based Study Michael H. Silber MB, ChB, 1 Lois E. Krahn MD, 2 Eric J. Olson MD, 3 V. Shane Pankratz PhD 4 1-3 Sleep Disorders
More informationJust sleep apnoea? R.L. Riha. Department of Sleep Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK. Correspondence
Patient Case A 17-yr-old man presented to the clinic with his mother after crashing his car. He had fallen asleep at the wheel and been referred urgently by his general practitioner. He had driven for
More informationPatterns of Sleepiness in Various Disorders of Excessive Daytime Somnolence
Sleep, 5:S165S174 1982 Raven Press, New York Patterns of Sleepiness in Various Disorders of Excessive Daytime Somnolence F. Zorick, T. Roehrs, G. Koshorek, J. Sicklesteel, *K. Hartse, R. Wittig, and T.
More informationExcessive Daytime Sleepiness Associated with Insufficient Sleep
Sleep, 6(4):319-325 1983 Raven Press, New York Excessive Daytime Sleepiness Associated with Insufficient Sleep T. Roehrs, F. Zorick, J. Sicklesteel, R. Wittig, and T. Roth Sleep Disorders and Research
More informationWhat s New In The Diagnosis and Management of Parasomnia and Hypersomnia?
What s New In The Diagnosis and Management of Parasomnia and Hypersomnia? Chitra Lal, MD, FCCP, FAASM Assistant Professor of Medicine, Medical University of South Carolina, Charleston, SC Author Disclosures
More informationUNDERSTANDING NARCOLEPSY
PATIENT GUIDE This brochure is designed to help you understand the symptoms of narcolepsy, so that you can discuss any symptoms you may be having with your doctor. UNDERSTANDING NARCOLEPSY Patient Counseling
More informationPredictors of Hypocretin (Orexin) Deficiency in Narcolepsy Without Cataplexy
PREDICTORS OF HYPOCRETIN DEFICIENCY IN NARCOLEPSY WITHOUT CATAPLEXY http://dx.doi.org/10.5665/sleep.2080 Predictors of Hypocretin (Orexin) Deficiency in Narcolepsy Without Cataplexy Olivier Andlauer, MD
More informationDisorders of Excessive Daytime Somnolence: Polygraphic and Clinical Data for 100 Patients
Sleep, 4(1):23-37 1981 Raven Press, New York Disorders of Excessive Daytime Somnolence: Polygraphic and Clinical Data for 100 Patients Johanna van den Hoed, Helena Kraemer, Christian Guilleminault, Vincent
More informationDiagnosis and treatment of sleep disorders
Diagnosis and treatment of sleep disorders Normal human sleep Sleep cycle occurs about every 90 minutes, approximately 4-6 cycles occur per major sleep episode NREM (70-80%) slow wave sleep heart rate,
More informationPeriodic Leg Movements in Narcolepsy
In: Nacrolepsy: Symptoms, Causes... ISBN: 978-1-60876-645-1 Editor: Guillermo Santos, et al. 2009 Nova Science Publishers, Inc. Chapter 7 Periodic Leg Movements in Narcolepsy Ahmed Bahammam * Sleep Disorders
More informationHypersomnolence in Psychiatric Disorders
Hypersomnolence in Psychiatric Disorders David T. Plante, M.D. Assistant Professor of Psychiatry Medical Director, Wisconsin Sleep Sleep Medicine Fellowship Director Duke Department of Psychiatry/Central
More informationNarcolepsy. Kelly Carden, MD St Thomas Medical Partners Sleep Specialists September 30, 2017 TSS Annual Meeting
Narcolepsy Kelly Carden, MD St Thomas Medical Partners Sleep Specialists September 30, 2017 TSS Annual Meeting Conflict of Interest Disclosures 1. I do not have any potential conflicts of interest to disclose,
More informationIndex SLEEP MEDICINE CLINICS. Note: Page numbers of article titles are in boldface type. Cerebrospinal fluid analysis, for Kleine-Levin syndrome,
165 SLEEP MEDICINE CLINICS Index Sleep Med Clin 1 (2006) 165 170 Note: Page numbers of article titles are in boldface type. A Academic performance, effects of sleepiness in children on, 112 Accidents,
More informationClinical Policy: Multiple Sleep Latency Testing
Clinical Policy: Reference Number: CP.MP.24 Last Review Date: 04/18 Coding Implications Revision Log See Important Reminder at the end of this policy for important regulatory and legal information. Description
More informationINTRODUCTION TO SLEEP MEDICINE (Non-Apnea)
INTRODUCTION TO SLEEP MEDICINE (Non-Apnea) Eric Ten Brock, MD, D.ABSM Professor of Medicine Division of Pulmonary, Cri=cal Care & Sleep Medicine State University of New York at Buffalo Why Sleep? Neuroplas+city
More informationIndex. sleep.theclinics.com. Note: Page numbers of article titles are in boldface type.
Note: Page numbers of article titles are in boldface type. A Accidents, risk of, with insufficient sleep, 318 Acquired immunodeficiency syndrome (AIDS), comorbid with narcolepsy, 298 299 Actigraphy, in
More informationUltrashort Sleep-Wake Cycle: Timing of REM Sleep. Evidence for Sleep-Dependent and Sleep-Independent Components of the REM Cycle
Sleep 10(1):62-68, Raven Press, New York 1987, Association of Professional Sleep Societies Ultrashort Sleep-Wake Cycle: Timing of REM Sleep. Evidence for Sleep-Dependent and Sleep-Independent Components
More informationAwake. Rapid Eye Movement (REM) or dreaming sleep. Normally, we go through Stages 2 to 5 a few times every night, before waking up in the morning.
Narcolepsy Need-to-Know Guide Childhood Narcolepsy This guide provides information for parents or carers of children and young people with narcolepsy. It aims to promote a clear understanding of the condition
More informationFocusing on Vigilance Instead of Sleepiness in the Assessment of Narcolepsy: High Sensitivity of the Sustained Attention to Response Task (SART)
NARCOLEPSY Focusing on Vigilance Instead of Sleepiness in the Assessment of Narcolepsy: High Sensitivity of the Sustained Attention to Response Task (SART) Rolf Fronczek, MSc; Huub A.M. Middelkoop, PhD;
More informationAssessment of Sleep Disorders DR HUGH SELSICK
Assessment of Sleep Disorders DR HUGH SELSICK Goals Understand the importance of history taking Be able to take a basic sleep history Be aware the technology used to assess sleep disorders. Understand
More informationWhich diagnostic findings in disorders with excessive daytime sleepiness are really helpful? A retrospective study
J Sleep Res. (2016) 25, 307 313 Excessive daytime sleepiness Which diagnostic findings in disorders with excessive daytime sleepiness are really helpful? A retrospective study UTE KRETZSCHMAR 1,2, ESTHER
More informationExcessive daytime sleepiness (EDS) is a prevalent complaint among patients in psychiatric
Continuing Education Column Excessive Daytime Sleepiness YoonKyung Shin, MDSeungChul Hong, MD Department of Psychiatry, The Catholic University of Korea College of Medicine Email : hscjohn@hotmail.com
More informationPolysomnography (PSG) (Sleep Studies), Sleep Center
Policy Number: 1036 Policy History Approve Date: 07/09/2015 Effective Date: 07/09/2015 Preauthorization All Plans Benefit plans vary in coverage and some plans may not provide coverage for certain service(s)
More informationTable of Contents RECOGNIZE SCREEN REFER. This brochure can help you: Narcolepsy Overview Narcolepsy Symptoms... 5
CLINICIAN GUIDE 1 This brochure can help you: RECOGNIZE possible manifestations of excessive daytime sleepiness, the cardinal symptom of narcolepsy 1-3 SCREEN all patients with manifestations of excessive
More informationRBD & other Parasomnias. Lauren A. Tobias MD Instructor of Medicine Yale University School of Medicine
RBD & other Parasomnias Lauren A. Tobias MD Instructor of Medicine Yale University School of Medicine Disclosures I have nothing to disclose Outline Defini@on Clinical overview & ICSD III classifica@on
More informationThe Multiple Sleep Latency Test: Individual Variability and Time of Day Effect in Normal Young Adults
Sleep 13(5):385-394, Raven Press, Ltd., New York 1990 Association of Professional Sleep Societies The Multiple Sleep Latency Test: Individual Variability and Time of Day Effect in Normal Young Adults M.
More informationUsefulness of a Nocturnal SOREMP for Diagnosing Narcolepsy with Cataplexy in a Pediatric Population
pii: sp-00430-14 http://dx.doi.org/10.5665/sleep.4728 NOCTURNAL SOREMP FOR DIAGNOSING NARCOLEPSY WITH CATAPLEXY IN CHILDREN Usefulness of a Nocturnal SOREMP for Diagnosing Narcolepsy with Cataplexy in
More informationCase Report Isolated Cataplexy in the Differential Diagnosis of Drop Attacks: A Case of Successful Clinical Diagnosis and Treatment
Case Reports in Neurological Medicine Volume 2012, Article ID 757586, 4 pages doi:10.1155/2012/757586 Case Report Isolated Cataplexy in the Differential Diagnosis of Drop Attacks: A Case of Successful
More informationNarcolepsy. Jon R. Doud, MD Pulmonary Physician Midwest Center for Sleep Disorders Aurora, IL
Narcolepsy Jon R. Doud, MD Pulmonary Physician Midwest Center for Sleep Disorders Aurora, IL Narcolepsy A central nervous system disorder that is an important cause of persistent sleepiness. The second
More informationThomas Roth Henry Ford Hospital
Thomas Roth Henry Ford Hospital Narcolepsy Network September 28, 2017 Tools for Diagnosing Narcolepsy Clinical history Sleep diary Questionnaires Sleep laboratory evaluation Polysomnography Multiple Sleep
More informationPaul Reading. Consultant Neurologist
Paul Reading Consultant Neurologist I. Defining the narcoleptic syndrome clinical features and diagnosis the role of investigations hypocretin (orexin) deficiency II. Case history III. Secondary narcolepsy
More informationMultiple Naps and the Evaluation of Daytime Sleepiness in Patients with Upper Airway Sleep Apnea
Sleep. 3(3/4):425-439 1980 Raven Press. New York, Multiple Naps and the Evaluation of Daytime Sleepiness in Patients with Upper Airway Sleep Apnea T. Roth, K. M. Hartse, F. Zorick, and W. Conway Sleep
More informationINTRINSIC SLEEP DISORDERS. Excessive daytime sleepiness (EDS) is a common complaint. Causes of EDS are numerous and include:
INTRINSIC SLEEP DISORDERS Introduction Excessive daytime sleepiness (EDS) is a common complaint. Causes of EDS are numerous and include: Intrinsic sleep disorders (e.g. narcolepsy, obstructive sleep apnoea/hypopnea
More informationPaediatric Narcolepsy: A Rare and Easily Forgotten Diagnosis
HK J Paediatr (new series) 2011;16:131-138 Paediatric Narcolepsy: A Rare and Easily Forgotten Diagnosis MM YAU, C DE SOUSA Abstract Key words Paediatric narcolepsy is a rare entity and remains under-diagnosed
More informationTable of Contents RECOGNIZE SCREEN DIAGNOSE. This brochure can help you: Narcolepsy Overview Narcolepsy Symptoms... 5
CLINICIAN GUIDE 1 This brochure can help you: RECOGNIZE possible manifestations of excessive daytime sleepiness, the cardinal symptom of narcolepsy 1-3 SCREEN all patients with manifestations of excessive
More informationNarcolepsy is a chronic sleep disorder producing. Narcolepsy in Saudi Arabia. Demographic and clinical perspective of an under-recognized disorder
Narcolepsy in Saudi Arabia Demographic and clinical perspective of an under-recognized disorder Ahmed S. BaHammam, FRCP, FCCP, Ahmed M. Alenezi, MBBS, ABIM. ABSTRACT Objectives: To assess the clinical
More informationNarcolepsy 101 The Past, The Present, The Future
Narcolepsy 101 The Past, The Present, The Future Todd J. Swick, M.D., FAASM, FAAN Assistant Clinical Professor of Neurology-The University of Texas School of Medicine-Houston Medial Advisory Board Member,
More informationStephanie Mazza, Jean-Louis Pepin, Chrystele Deschaux, Bernadette Naegele, and Patrick Levy
Analysis of Error Profiles Occurring during the OSLER Test A Sensitive Mean of Detecting Fluctuations in Vigilance in Patients with Obstructive Sleep Apnea Syndrome Stephanie Mazza, Jean-Louis Pepin, Chrystele
More informationN arcolepsy is characterised by two major symptoms,
1667 PAPER CSF hypocretin-1 levels in narcolepsy, Kleine-Levin syndrome, and other hypersomnias and neurological conditions Y Dauvilliers, CR Baumann, B Carlander, M Bischof, T Blatter, M Lecendreux, F
More informationNarcolepsy UPDATES. Disclosure
Narcolepsy UPDATES Rose A. Franco, MD Associate Professor of Pulmonary, Critical Care and Sleep Medicine Medical College of Wisconsin Disclosure No conflicts of interest 1 Narcolepsy Type 1 (Narcolepsy
More informationSleep latency testing as a time course measure of state arousal
J. Sleep Res. (2005) 14, 387 392 Sleep latency testing as a time course measure of state arousal MICHAEL H. BONNET 1,2,3 and DONNA L. ARAND 2,3 1 Dayton Department of Veterans Affairs Medical Center, 2
More informationThe Alpha Attenuation Test: Assessing Excessive Daytime Sleepiness in Narcolepsy-Cataplexy
Sleep, 20(4):258-266 1997 American Sleep Disorders Association and Sleep Research Society.j The Alpha Attenuation Test: Assessing Excessive Daytime Sleepiness in Narcolepsy-Cataplexy Christi E. D. Alloway,
More informationMolDX: HLA-DQB1*06:02 Testing for Narcolepsy
MolDX: HLA-DQB1*06:02 Testing for Narcolepsy CGS Administrators, LLC Jump to Section... Please Note: This is a Proposed LCD. Proposed LCDs are works in progress and not necessarily a reflection of the
More informationDr. Alessio Signori Longitudinal trajectories of EDSS in primary progressive MS pa:ents A latent class approach
Dr. Alessio Signori Longitudinal trajectories of EDSS in primary progressive MS pa:ents A latent class approach Department of Health Sciences Section of Biostatistics University of Genoa, Italy Mul%ple
More informationSymptoms of Narcolepsy
Symptoms of Narcolepsy v Sleep attacks Brief episodes of sleep that occur many times a day May occur without warning or be preceded by drowsiness Patient usually feels refreshed afterwards Refractory period
More information10/19/17. Perioperative Management of the Patient with Narcolepsy. Financial Disclosures. UpToDate written 2 sections
Perioperative Management of the Patient with Narcolepsy Dennis Auckley, MD Director, Center for Sleep Medicine MetroHealth Medical Center Professor of Medicine Case Western Reserve University October 2017
More informationSleep Disorders. Anneka Rose ST5 Psychiatrist
Sleep Disorders Anneka Rose ST5 Psychiatrist Agenda Basic overview of sleep structure Interactive case based discussions 5 min interventions MCQs Questions Hypnogram Actigraphy Common Scenario Patient
More informationDaytime Alertness in Patients with Chronic Insomnia Compared with Asymptomatic Control Subjects
Sleep I ():54-60, Raven Press, Ltd., New York 988 Association of Professional Sleep Societies Daytime Alertness in Patients with Chronic Insomnia Compared with Asymptomatic Control Subjects Edward Stepanski,
More informationATHLETES & PRESCRIBING PHYSICIANS PLEASE READ
ATHLETES & PRESCRIBING PHYSICIANS PLEASE READ USADA can grant a Therapeutic Use Exemption (TUE) in compliance with the World Anti- Doping Agency International Standard for TUEs. The TUE application process
More informationObjective markers for sleep propensity: comparison between the Multiple Sleep Latency Test and the Vigilance Algorithm Leipzig
J Sleep Res. (2015) 24, 450 457 Markers for sleep propensity Objective markers for sleep propensity: comparison between the Multiple Sleep Latency Test and the Vigilance Algorithm Leipzig SEBASTIAN OLBRICH
More informationNarcolepsy with Cataplexy: Treatment Tailored to the Patient
CLINICAL VIGNETTE Narcolepsy with Cataplexy: Treatment Tailored to the Patient Gregory Bierer, MD, Laura R. Banashek BA, Eugenia Wen, MD The patient sought the care of a sleep physician at the age of 20
More informationGuidelines for the Multiple Sleep Latency Test (MSLT): A Standard Measure of Sleepiness *
Sleep 9(4):519-524, Raven Press, New York 1986, Association of Professional Sleep Societies Guidelines for the Multiple Sleep Latency Test (MSLT): A Standard Measure of Sleepiness * Chairman: Mary A. Carskadon
More informationCorporate Medical Policy
Corporate Medical Policy Polysomnography for Non Respiratory Sleep Disorders File Name: Origination: Last CAP Review: Next CAP Review: Last Review: polysomnography_for_non_respiratory_sleep_disorders 10/2015
More informationCircadian rhythms and attentional dysfunction in type 1 Narcolepsy
Alma Mater Studiorum Università di Bologna DOTTORATO DI RICERCA IN Scienze Psicologiche Ciclo XXVIII Settore Concorsuale di afferenza: 11/E1 Settore Scientifico disciplinare: M-PSI/01 Circadian rhythms
More informationSleepiness, Fatigue, Tiredness, and Lack of Energy in Obstructive Sleep Apnea*
Sleepiness, Fatigue, Tiredness, and Lack of Energy in Obstructive Sleep Apnea* Ronald D. Chervin, MD, MS Study objectives: Sleepiness is a key symptom in obstructive sleep apnea syndrome (OSAS) and can
More informationSleep Medicine. Maintenance of Certification Examination Blueprint. Purpose of the exam
Sleep Medicine Maintenance of Certification Examination Blueprint Purpose of the exam The exam is designed to evaluate the knowledge, diagnostic reasoning, and clinical judgment skills expected of the
More informationNSD Application Specialist Sleep Service for Narcolepsy and Violent Parasomnias
Meeting: NoSPG Date: 30 th November 2011 Item: 72/11 (d) NHS LOTHIAN Senior Management Team Thursday 26 th May 2011 (revised costings) Lyn McDonald: Director of Operations Medicine Associated Services
More informationSleep Patients with Daytime SOREMs Exhibit More Daytime Sleepiness but Similar Fatigue
Sleep Patients with Daytime SOREMs Exhibit More Daytime Sleepiness but Similar Fatigue Alison L. Gibbs, PhD, PStat March 10, 2011 Summary: This report considers whether sleep clinic patients with daytime
More informationThe Multiple Sleep Latency Test: What Does It Measure?
Sleep,5:S67-S72 1982 Raven Press, New York The Multiple Sleep Latency Test: What Does It Measure? Mary A. Carskadon and William C. Dement Stanford University Sleep Research Center, Stanford, California
More informationResolving the PSA testing controversy. Professor Villis Marshall AC Professor Bruce Armstrong AM Professor Mark Frydenberg
Resolving the PSA testing controversy Professor Villis Marshall AC Professor Bruce Armstrong AM Professor Mark Frydenberg Professor Villis Marshall AC Introduc)on Guidelines aim to inform tes)ng for the
More informationNARCOLEPSY IN CHILDHOOD AND ADOLESCENCE
NARCOLEPSY IN CHILDHOOD AND ADOLESCENCE RUBENS REIMÃO * HÉLIO LEMMI ** SUMMARY The objective of this study was to evaluate clinical, polysomnography and the multiple sleep latency test (MSLT) features
More informationThe Role of PCP in Prostate Cancer Screening Beaver Creek Ma< T. Rosenberg
The Role of PCP in Prostate Cancer Screening Beaver Creek 2017 Ma< T. Rosenberg A Cri@cal Look at the Historical Flow Pa@ent concern Office visit History DRE PSA Biopsy Specimen with pathologist Too Many
More informationSLEEP DISORDERS. Kenneth C. Sassower, MD Division of Sleep Medicine; Department of Neurology Massachusetts General Hospital for Children
SLEEP DISORDERS Kenneth C. Sassower, MD Division of Sleep Medicine; Department of Neurology Massachusetts General Hospital for Children Distinctive Features of Pediatric Sleep Daytime sleepiness uncommon
More informationAppendix 1. Practice Guidelines for Standards of Adult Sleep Medicine Services
Appendix 1 Practice Guidelines for Standards of Adult Sleep Medicine Services 1 Premises and Procedures Out-patient/Clinic Rooms Sleep bedroom for PSG/PG Monitoring/Analysis/ Scoring room PSG equipment
More informationSleep and Sleep Hygiene in an Occupational Health & Safety Context
Sleep and Sleep Hygiene in an Occupational Health & Safety Context Glenn Legault Ph.D. Center for Research in Occupational Safety and Health, Laurentian University Nov. 12, 2014 Overview: Sleep what is
More informationNarcolepsy with cataplexy and comorbid immunopathological
J Sleep Res. (2014) 23, 414 419 Narcolepsy and comorbidities Narcolepsy with cataplexy and comorbid immunopathological diseases FRANCISCO J. MARTÍNEZ-OROZCO 1, JOSÉ L. VICARIO 2, ISABEL VILLALIBRE-VALDERREY
More informationINSOMNIAS. Stephan Eisenschenk, MD Department of Neurology
INSOMNIAS INSOMNIAS General criteria for insomnia A. Repeated difficulty with sleep initiation, duration, consolidation or quality. B. Adequate sleep opportunity, persistent sleep difficulty and associated
More informationChecklist for Completion of Training Requirements in Sleep Medicine Pathway 2
Checklist for Completion of Training Requirements in Sleep Medicine Pathway 2 This checklist follows the mandatory components of training in sleep medicine for physicians who have followed Pathway 2. Please
More informationAn 18-Year-Old Woman with Prolonged Eyes Closed Unresponsiveness during Multiple Sleep Latency Testing
pii: jc-00317-16 http://dx.doi.org/10.5664/jcsm.6410 SLEEP MEDICINE PEARLS An 18-Year-Old Woman with Prolonged Eyes Closed Unresponsiveness during Multiple Sleep Latency Testing Romy Hoque, MD 1 ; Victoria
More informationsleep latencies Arousal and sleepiness in insomnia patients the tendency to fall asleep
Arousal and sleepiness in insomnia patients Sleepiness the tendency to fall asleep Elke De Valck, Raymond Cluydts, Sandra Pirrera Department of Cognitive and Physiological Psychology, Vrije Universiteit
More informationSleep disorders. Norbert Kozak
Sleep disorders Norbert Kozak About the sleep Each of us will spend about 1/3 of our lifetime sleeping....and 1/3 part of the population has sleep complain Sleep is an essential biological function, but
More informationRestful Sleep or Getting Up to Eat? Suvorexant (Belsomra )
Restful Sleep or Getting Up to Eat? Suvorexant (Belsomra ) Alyssa Penick, PharmD PGY1 Pharmacy Resident UC Health- University of Cincinnati Medical Center Insomnia Most common sleep disorder Defined as
More informationCOMMUNICATIONS NARCOLEPSY: PROBLEMS OF DIAGNOSIS AND TREATMENT. N. Gordon, Paediatric Neurologist, Huntlywood, 3 Styal Road, Wilmslow
NARCOLEPSY: PROBLEMS OF DIAGNOSIS AND TREATMENT N. Gordon, Paediatric Neurologist, Huntlywood, 3 Styal Road, Wilmslow Narcolepsy (Gelineau s syndrome) is an unusual syndrome and that may be one of the
More informationFEP Medical Policy Manual
FEP Medical Policy Manual Effective Date: October 15, 2018 Related Policies: 2.01.18 Diagnosis and Medical Management of Obstructive Sleep Apnea Syndrome Polysomnography for Non-Respiratory Sleep Disorders
More informationFEP Medical Policy Manual
FEP Medical Policy Manual Effective Date: January 15, 2018 Related Policies: 2.01.18 Diagnosis and Medical Management of Obstructive Sleep Apnea Syndrome Diagnosis and Medical Management of Obstructive
More informationSleep 101. Kathleen Feeney RPSGT, RST, CSE Business Development Specialist
Sleep 101 Kathleen Feeney RPSGT, RST, CSE Business Development Specialist 2016 Why is Sleep Important More than one-third of the population has trouble sleeping (Gallup) Obstructive Sleep Apnea Untreated
More informationReview Article A Practical Approach to Excessive Daytime Sleepiness: A Focused Review
Canadian Respiratory Journal Volume 2016, Article ID 4215938, 4 pages http://dx.doi.org/10.1155/2016/4215938 Review Article A Practical Approach to Excessive Daytime Sleepiness: A Focused Review Brian
More informationCover Page. The handle holds various files of this Leiden University dissertation.
Cover Page The handle http://hdl.handle.net/1887/49010 holds various files of this Leiden University dissertation. Author: Heide, A. van der Title: Unravelling narcolepsy : from pathophysiology to measuring
More information1/28/2015 EVALUATION OF SLEEP THROUGH SCALES AND LABORATORY TOOLS. Marco Zucconi
EVALUATION OF SLEEP THROUGH SCALES AND LABORATORY TOOLS Marco Zucconi Sleep Disorders Centre, Dept of Clinical Neurosciences, San Raffaele Hospital, Milan, Italy INDAGINI STRUMENTALI DEL CICLO SONNO-VEGLIA
More informationHypersomnolence. Fang Han MD Nikolas Netzer MD PhD June 2013
Hypersomnolence Fang Han MD Nikolas Netzer MD PhD June 2013 Definitions of Hypersomnolence (DSM IV, AASM, ICSD) Real hypersomnia: Hypersomnolence is measurable with a positive MSLT and ESS score, sleep
More informationCoding for Sleep Disorders Jennifer Rose V. Molano, MD
Practice Coding for Sleep Disorders Jennifer Rose V. Molano, MD Accurate coding is an important function of neurologic practice. This section of is part of an ongoing series that presents helpful coding
More informationAxsome Announces AXS-12 for Narcolepsy
NASDAQ: AXSM Axsome Announces AXS-12 for Narcolepsy Conference Call October 16, 2018 Overview AXS-12 and Unmet Needs in Narcolepsy Introduction Summary AXS-12 Overview and Clinical Development Clinical
More informationUnderstanding Narcolepsy Frequently Asked Questions
Understanding Narcolepsy Frequently Asked Questions What is narcolepsy? Narcolepsy is a serious, life-long disorder caused by the brain s inability to regulate sleep-wake cycles normally, involving irregular
More informationUnitedHealthcare Pharmacy Clinical Pharmacy Programs
UnitedHealthcare Pharmacy Clinical Pharmacy Programs Program Number 2018 P 2021-10 Program Prior Authorization/Medical Necessity Medication Xyrem (sodium oxybate) P&T Approval Date 4/2014, 8/2014, 4/2015,
More informationPsychological characteristics of patients with myotonic dystrophy type 1.
20 per page Sort by Most Recent Clipboard Items: 9 Remove all items. Acta Neurol Scand. 205 Jul;32():49 58. doi: 0./ane.2356. Epub 204 Dec. Psychological characteristics of patients with myotonic dystrophy
More informationEVIDENCE TABLES The Clinical use of the MSLT and MWT
1 EVIDENCE TABLES The Clinical use of the MSLT and MWT Table I. MSLT IN NARCOLEPSY Alloway 96 / C3 Design / Test Protocol / #naps / SL definition Case-control volunteer / MSLT clinical / 5 naps / 20 min
More informationRelationship of Autonomic Nervous System Activity to Daytime Sleepiness and Prior Sleep
Sleep 12(3):239-245, Raven Press, Ltd., New York 1989 Association of Professional Sleep Societies Relationship of Autonomic Nervous System Activity to Daytime Sleepiness and Prior Sleep Mark R. Pressman
More informationI MSLT=multiple sleep latency test; MWI'=mainteDance of I
Maintenance of Wakefulness Test and Multiple Sleep Latency Test* Measurement of Different Abilities in Patients With Sleep Disorders Rahul B. Sangal, M.D.;t Larry Thomas;t and Merrill M. Mitler, Ph.D:;f:
More informationThe wake-promoting agent modafinil is an effective
Excessive sleepiness associated with narcolepsy lasts throughout the waking day. The authors conducted two randomized, double-blind studies to compare the efficacy of modafinil once-daily versus split
More informationTOP 10 LIST OF SLEEP QUESTIONS. Kenneth C. Sassower, MD Sleep Disorders Unit Massachusetts General Hospital for Children
TOP 10 LIST OF SLEEP QUESTIONS Kenneth C. Sassower, MD Sleep Disorders Unit Massachusetts General Hospital for Children QUESTION #1: ARE SLEEP ISSUES IN CHILDREN THE SAME AS IN ADULTS? Distinctive Features
More informationWhat Is the Moment of Sleep Onset for Insomniacs?
Sleep, 6(1): 10-\5 1983 Raven Press, New York What Is the Moment of Sleep Onset for Insomniacs? Peter Rauri and Elaine Olmstead Dartmouth Medical School, Hanover, New Hampshire, U,S,A, Summary: Subjective
More information2017 Elsevier Ltd. This manuscript version is made available under the CC-BY-NC-ND 4.0 license
This is a repository copy of Narcolepsy and Cataplexy a practical approach to diagnosis and managing the impact of this chronic condition on children and their families. White Rose Research Online URL
More information